全髋关节置换术治疗成人先天性髋关节脱位的常见困难及对策  

Frequently encounted difficulties and counter measure for treatment of congenital dislocation of hip joint with hip replacement in adults

作　　者：索鹏[1] 梅汉尧[1] 周永顶[1] 王浩杰[1] 陈坚[1] 

机构地区：[1]五邑中医院,暨南大学医学院第六附属医院骨科,广东江门529000

出　　处：《中国骨伤》2005年第1期17-19,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的介绍全髋关节置换术治疗成人先天性髋关节脱位的经验。方法1997年4月-2000年4月,对16例18髋成人先天性髋关节脱位的患者进行全髋关节置换手术,其中单侧14例,双侧2例。假体类型非骨水泥型10髋、混合型6髋、骨水泥型2髋。随访时间平均38年(32～46年)。结果术后伤口均Ⅰ期愈合。无血管及神经并发症出现。11髋术后肢体恢复等长,其余7髋较健侧缩短,但均<10mm。平均Harris评分由术前52分增至术后92分。随访期未发现假体松动及脱位。结论全髋关节置换术治疗成人先天性髋关节脱位的手术比较复杂、并发症多,术前应有周密的计划,术中特别需要考虑肢体长度均衡、假体的选择、髋臼骨床的制备及安置。Objective:To introduce the experiences of total hip replacement(THR)in the treatment for congenital dislocation of hip(CDH)in adults.Methods:From April 1997 to April 2000,eighteen hips in sixteen adult patients diagnosed as CDH were treated with THR,include ten patients of cementless type,six patients of hybrid type and two patients of cement type.The time of following-up was 3.2 to 4.6 years,with a mean value of 3.8 years.Results:The incision healed smoothly.There were no complication related to the nerve and vessel.Out of the eleven hips with shortened leg less than 10 mm.The average Harris score was increased from 52 to 92 scores after operation.Neither loosening nor dislocation of the prostheses occurred in duration of following-up.Conclusion:THR in patients of CDH is complicated.The careful preoperative planning should be made.The technical diffculties encountered during operation,included the correction of the length of bilateral lower extremities,the balance of the abductor muscles,the release of the soft tissue,the dealing of the superior segmental defect of acetabulum and selection of the components,etc.

关 键 词：治疗 先天性髋关节脱位 全髋关节置换术 并发症 常见 术前 术后 对策 困难 均衡 

分 类 号：R687.4[医药卫生—骨科学] R735.7[医药卫生—外科学]